I think Maddow's best point is that the health insurance companies aren't interested at all in the health of any Americans (except their executives). What is good for the insurance companies is bad for health. They aren't health care companies at all; they're medical care rationing companies, practicing triage by excluding those most likely to actually need care.
I wish I'd seen this before I went to hear Gary Johnson. The point that providing more competition is actually not a change at all is a potent one: so long as profit is the motive, companies will endeavor to excel at collecting premiums and providing as near to nothing as they can manage.
Competition is a good idea. However, if you just let the current players play, there won't really be competition, there will be the status quo. The way to provide competition would be to provide massive incentives for citizens to combine into fraternal companies, which provide far more per dollar than for-profit outfits. Let the Elks run an insurance company for their members, let every national church body run its own, let gays have our own if we want. Base insurance not on profit but on community, and let people choose their community.
Make sure there's at least one large fraternal organization in every state and a hundred more, and the for-profit people will have to actually start to care about health, and not just profit.
